摘要
目的探讨关节镜清理术配合中药超声导入治疗膝骨性关节炎的疗效,为其临床研究提供参考依据。方法选择94例诊断为膝骨性关节炎的患者作为研究对象,采用随机数字法平均分为观察组与对照组各47例。对照组给予关节镜清理术治疗,观察组在关节镜清理术基础上配合中药超声导入治疗。于治疗前、治疗后1月、3月及6月采用疼痛视觉模拟评分(VAS)评价患者疼痛状态,采用Lysholm评分及IKDC评分(膝关节功能)评价膝关节功能,采用《中医病证诊断疗效标准》评价治疗疗效。于治疗前、治疗后1、7及14 d采用ELISA法(酶联免疫吸附法)检测血清炎症因子水平:前列腺素E2(PGE2)、白细胞介素-1β(IL-1β)。结果两组治疗后疼痛积分均逐渐降低(P<0.05);治疗后1月、3月、6月观察组疼痛积分均低于对照组(P<0.05)。两组治疗后WOMAC量表功能评分均逐渐降低(P<0.05);治疗后1月、3月、6月观察组WOMAC量表功能评分均低于对照组(P<0.05)。6月后观察组总有效率95.7%(45/47)明显高于对照组83.0%(39/47)(P<0.05)。治疗后1 d两组PGE2、IL-1β水平均较治疗前升高(P<0.05),治疗后7d两组PGE2、IL-1β水平均逐渐降低(P<0.05);治疗后1、7、14 d观察组PGE2、IL-1β水平均低于对照组(P<0.05)。结论关节镜清理术配合中药超声导入治疗可以更好的降低膝骨性关节炎的疼痛,更好的促进膝关节功能恢复,提高治疗效果,同时可以更明显的降低炎症因子,值得临床应用。
Objective To investigate the effect of arthroscopic debridement combined with the ultrasonic introduction of traditional Chinese medicine on knee osteoarthritis, and provide a reference for its clinical research. Methods Ninety-four patients with knee osteoarthritis were selected as the research objects, and they were equally divided into observation group and control group by random number method. The control group was given arthroscopic debridement, and the observation group was combined with ultrasonic introduction of traditional Chinese medicine on the basis of arthroscopic debridement. Before treatment and 1, 3 and 6 months after treatment, pain visual analogue score(VAS) was used to evaluate the pain state of patients, Lysholm score and IKDC score(knee joint function) were used to evaluate knee joint function. Serum levels of prostaglandin E2(PGE2) and interleukin-1β(IL-1β) were measured by ELISA(enzyme-linked immunosorbent assay) before treatment, 1 d, 7 d and 14 d after treatment. Results The pain scores of the two groups were gradually reduced after treatment(P<0.05). The pain scores of the observation group were lower than those of the control group at 1, 3 and 6 months after treatment(P<0.05). The functional scores of the WOMAC scale in the two groups were decreased gradually after treatment(P<0.05). The functional scores of the WOMAC scale in the observation group at 1, 3 and 6 months after treatment were lower than those in the control group(P<0.05). After 6 months, the total effective rate in the observation group was 95.7%(45/47), which was significantly higher than that in the control group(83.0%,39/47)(P<0.05). The levels of PGE2 and IL-1β in the two groups were higher than those before treatment on the 1 st day after treatment(P<0.05), and the levels of PGE2 and IL-1β in the two groups were gradually decreased on the 7 th day after treatment(P<0.05). 1 d, 7 d and 14 d after the treatment, the levels of PGE2 and IL-1β in the observation group were lower than those in the control group(P<0.05). Conclusion Arthroscopic debridement combined with the ultrasonic introduction of traditional Chinese medicine can better reduce the pain of knee osteoarthritis, promote the knee joint function recovery, improve the treatment effect and reduce the inflammatory factors more significantly, which is worthy of clinical application.
作者
尹红梅
支慧
胡楠
李温霞
樊孝文
黄金承
赵甲军
YIN Hongmei;ZHI Hui;HU Nan;LI Wenxia;FAN Xiaowen;HUANG Jincheng;ZHAO Jiajun(Henan People's Hospital,Zhengzhou 450003,Henan,China;The First Affiliated Hospital of Henan College of Traditional Chinese Medicine,Zhengzhou 450000,Henan,China)
出处
《中华中医药学刊》
CAS
北大核心
2021年第7期35-38,共4页
Chinese Archives of Traditional Chinese Medicine
基金
国家中医药管理局中医药行业科研项目(20182633)
河南省科技攻关项目(202102310113)。
关键词
关节镜清理术
中药
超声
膝骨性关节炎
arthroscopic debridement
traditional Chinese medicine
ultrasound
knee osteoarthritis
